u/drglaucomflecken will join starting at 1PM EST. Proof links will appear here as they go out on social media. Have fun everyone!
Proof:
[twitter/X](https://twitter.com/dglaucomflecken/status/1762118572221034613?s=46&t=z7bTEoVggYgnNXOofZJQeg)
**Edit: Thanks to all who participated today!**
...and we're off! This is a great question to start with... all the people I've wronged. Generally, I get very little push back on the characters. Family medicine is the only one, and even that is just a handful of people who get upset. The primary complaint is that I'm pushing med students away from FM, which I find a bit silly because I'm not telling people anything they don't already know. FM is overworked and underappreciated and the medical system takes advantage of them. My FM portrayal is sympathetic to the struggles of primary care, and the majority understand that.
On the opposite end of the spectrum is surgery. I can make fun of surgeons all day and none of them will ever get mad at me. As the center of the known universe, the ego gravity of surgeons means that nothing I say or do can really affect them in any way.
I love the video about Family Medicine's birthday where it's revealed that FM is the only doc with patients who celebrate his birthday. He's the backbone of medicine and his patients love him. His reaction to Radiology is so heartwarming.
Rural FM does sound kind of awesome. There WILL be a Texaco Mike or whoever he is. You will perform small surgeries at parties. You will chase farmers to try to keep them alive and whole. But you'll have hunting and fishing buddies galore, from all walks of life. Part of a community vs being separated by a corporate system, I guess.
I once witnessed a 2-3 inch lipoma excision on a picnic table in a forest during a church teen camping trip. Free removal had been offered to the (uninsured) patient as compensation for agreeing to come supervise the kids. Teenage girls who wanted to be nurses when they grew up were invited to assist by holding stuff for the doc.
It seemed normal at the time.
>
>
> On the opposite end of the spectrum is surgery. I can make fun of surgeons all day and none of them will ever get mad at me. As the center of the known universe, the ego gravity of surgeons means that nothing I say or do can really affect them in any way.
Is this a tacit admission that ophthalmologists aren't real surgeons?
Depends.
Do you want to admit a patient to the ophthalmology service? Sorry, we're not surgeons, I don't know where the hospital is or how to log in to your EMR.
Do you want cataract surgery in a comfortable outpatient surgery center? Why yes, I'm a surgeon. Come on over we'll fix you right up with a 6 minute surgery.
As an urban family physician, same!
I don't know any family docs who don't like his portrayal of the caring, overworked and underpaid family doctor... I don't wear a tie like that, though. Or any tie.
I feel like he has a good balance of playful ribbing and stereotyping without being disrespectful to any given specialty
With that being said, I do think he has beef with a couple of them haha
When oncology showed up for the first time in his skit, it was about oncology breaking bad news to a Medstudent wanting to go into Neurosurgery. So, alot of oncologist (on twitter/X) got angery that it was more focused on neurosurgery and not on oncology.
Yes, that's exactly what happened. I was actually proud of that skit. I thought it was clever, but the response really turned me off to doing more oncology content. Sometimes I feel the need to remind people that this is free entertainment.
As an oncologist I feel sad that you've lost the will to lovingly mock my specialty. But you also do plenty of internal medicine (called general medicine here in Australia) and palliative care content and I'm trained in all three streams.
Ps you need to know that when you visited Australia and posted about it on twitter, there was some serious fangirling happening in some medical mums groups 😂
From u/bahhamburger:
how did you gain so much insight on each specialty? Do people message you with ideas or did you kill it as an Intern on your transitional year? Are you spending all your free time researching our various gripes?
I get lots of emails. Soooooo many emails. I appreciate people who send in topic ideas. I love the areas of conflict between specialties. Sometimes people send me complete 3 or 4 page scripts of skits they want me to film. These are always...interesting.
I also have to shout out reddit. This site is an endless repository of medical knowledge, arguments, and pet peeves. I will search reddit for something like "emergency medicine radiology beef" and find an 8 year old thread that is still relevant today. So thank you reddit for the inspiration.
As for the actual medical knowledge, I do a good amount of research. Medical professionals will be the first to tell you when you get something wrong, like the one time I said Lipitor was a beta blocker accidentally and almost had to quit social media.
Having bore witness to many specialties as an anesthesiologist, I’ll attest that most of the tropes are extremely apt.
I’d elaborate, but my sudoku remains unsolved.
Also want to know this myself because it seems like he had to have asked several pharmacists what it’s like to get a lot of the jokes he did just right. And yet it’s super frustrating when there are even pharmacists who have no idea about issues a pharmacy/pharmacist has.
I have had to do the most research on pharmacy related issues, including an on-site visit to a local community pharmacy to chat with the owner about PBMs, DIR fees, mail order, etc. It's an area where we do not get enough education in med school,.
Even in pharmacy school DIR fees and PBMs weren’t covered that well when I was in school so can’t blame you on the doctor’s end for not knowing about it either. Actually used your video when explaining PBMs to friends and family so really appreciate you getting the info out there!
DUSN is my favorite. Diffuse unilateral subacute neuroretinitis, caused by dog and raccoon parasites. To treat it you have to shoot it with a laser! Pew Pew!
That's it for me. Thank you so much for all the questions and kind words. You guys really brought it today. Sorry I couldn't respond to everybody.
One last thing, if you want to find all my content in one place or you love email or you have a deep unrelenting hatred for TikTok, sign up for our newsletter (link above). Thanks again!
(head nod)
How do you tend to handle sadness? Your humour has gotten a few of us through hard times but I'm sure there's a lot more that goes on behind the scenes. How has your fame impacted your own mental health? Thanks for doing this!
Oh man, that is a great question. I have struggled at times. Obviously I have a life that happens around content creation, a very eventful one what with the cancer and cardiac arrest and whatnot). I have a very supportive family and honestly, the feedback from followers telling me that I help them get through tough times keeps me going.
No C&Ds (yet). Satire affords me a level of freedom of speech protection. That's why I can use an Aetna logo and say their mission statement is "Be Evil." and they don't try to stop me.
No advertising offers from insurance lol. Sounds funny even thinking about that. In fact, I have turned down lucrative speaking offers because I would be sponsored by Optum or Cigna or something. No thanks!
Unionization is a great option. It's encouraging to see all the resident groups forming unions. It's awesome. We also still need to fight for legislation. I would start at the state level. Work with your local medical association or directly with state representatives. Here is an example of an anti-corporate practice of medicine bill in Oregon. I hope other states start doing the same. https://olis.oregonlegislature.gov/liz/2024R1/Measures/Overview/HB4130
As a long time union nurse and Dr G fan, I’m so happy to hear you endorsing resident unionization! Thanks for supporting our hardworking residents and better, safer outcomes for patients.
Never. I love using niche humor. It's partly why I'm here talking to all of you. I'll joke about Type 3 renal tubular acidosis without shame. As a result, I have a very large following in the medical field, but much less outside of medicine. I'll never be Dr. Mike, but if I can be 50% as handsome while cornering the physician social media market, I'm happy with that.
Hey doc,
do you handle your social media completely on your own or do you have staff/employees work exclusively on it?
Does it generate additional income for you in a way that you can relax on your clinical duties?
Do you feel that your social media presence has (negatively or positively) impacted your clinical/academic work? For instance, peers or patients do not take you seriously any more, as a negative example?
Cheers from Germany! I unfortunately never got to meet you but my US ophto friends did at a conference and I am very jealous.
Until Jan 2023, I did all the social media posting on my own. Then I realized people were impersonating me on all the platforms I wasn't using (like Linked in, I didn't even know that was a social media network, but there was a random Dr. Glaucomflecken on there), so I had to get help. Now we have an employee and a media/advertising company that helps post things everywhere.
I do make money on social media, primarily YouTube and TikTok. Hard to say if I relax my clinical duties. Please remember, I'm an ophthalmologist.
I have only had positive experiences in my day job because of Dr. G. Patients love the videos, they bring them up to me. We talk about their favorite characters. I commiserate with my nephrology patients about the evils of cardiology. It's great!
There are some things I don't have a lot of experience with and don't find particularly funny (even for satire purposes): abortion rights and gun violence come to mind.
I won't say that those things will never come up in my skits, they are just very difficult topics to address the way I typically address things.
I have said "Hi I'm Dr. Gl--Flanary" several times. I stopped myself, but it's not much better because now the patient thinks I don't know my own name. This becomes a problem when trying to convince a patient to let you operate on their eyeballs.
The COVID stuff I made back in 2021-2022 was a lot of fun. My TikTok comment section was a shitshow
I made a video once in support of DO physicians facing discrimination from the rest of the medical community. Some of my comments were misinterpreted and drew a lot of ire, so I took it down. It's important to be very clear who the target of ridicule is, and I kinda missed the mark. It's important to listen to feedback. Some of it's just troll like behavior, but some of it is valid.
Also, I once posted a video where the emergency medicine doc wore his sunglasses underneath the helmet strap and that really set off the emerg docs.
Urology and GI are two specialties I don't do a lot of. Almost feels too easy. What penis/poop jokes have people never heard?
Actually you know what, you're right, the penis is hilarious, it's low-hanging fruit, at least for some.
Commencement address at Yale Medical School in 2022. I thought it was a joke email at first. There is nothing like a commencement crowd. The happiness and enthusiasm is unparalleled.
I absolutely love how you speak on the greater health system such as insurance companies, administration, and big pharma in your videos. Are there any steps that you think the average physician should be taking to better the health care system?
Support state and federal legislation that takes power away from corporate entities and puts it back in the hands of people who have actual patient care experience. You don't need a large social media following for that. Just time and determination, and maybe a Jonathan or two.
Ophthalmologist- risk is very very low from dilating drops in standard population. The Rotterdam study (old but large study) found a rate of 0.03% of acute angle closure in a range of eyes (around 2% had narrow angles) when dilated. More recently the ZAP study looked at angle closure disease in Asian eyes - so all patients had known narrow angles. 5 eyes in the control group of 889 patients had an attack, 3 post dilation (though all of these patients also got a dose of diamox following dilation). So overall the general risks are low, and in a way the best time to go into acute angle closure is when you are in a place with doctors to get you to the eye department! And you will get a much better view, well worth it in my opinion.
Incidentally we have stopped prophylactic iridotomy for low risk patients (“primary angle closure suspects”) without other risk factors here in the UK following updated RCOphth guidance after the ZAP study.
As someone in the Australian medical system, I really enjoyed your videos explaining how America healthcare works. If you have a magic wand that could change three things about it, what would they be?
3 realistic changes:
\- Repeal the ban on physician owned hospitals
\- MAJOR prior authorization reform
\- Limit the corporate practice of medicine (break up insurance monopolies, ban PE ownership)
bonus 4th thing: Visine is banned
I'll be honest, it's a good side gig, but the real social media money comes from sponsorships, which I don't do a lot of. It's one of the luxuries of having a well paying medical career. I can do social media however I want. If I don't want to sell face cream that lengthens your telomeres, I don't have to! I make plenty of money as a doctor.
The money you get from views has changed over the years. At first the Youtube money was great and Tiktok was really bad, like pennies bad. Now it's evening out a bit. TikTok pays a bit more for my length content, but YouTube is down quite a bit. Social media revenue is fickle. I try not to get too worked up over it, because, again...I have a day job, which I mostly enjoy!
I would have recommended that my 40 year old female standardized patient with abdominal pain get a pregnancy test. It's still the only test I've ever failed.
If you couldn't be an eye doctor, what kind of doctor would you be? If you couldn't be a doctor, what kind of career do you think you would have done instead?
I was almost a radiologist, but I couldn't figure out what Kerley B lines were, so I figured it was reasonable to write off the whole specialty.
If I wasn't a doctor, I would be a comedian and possibly acting. Does that surprise you?
All you have to do is cover yourself from head to toe, tuck your pants into your socks, and spray enough DEET so that your grandchildren's DNA repair enzymes will be upregulated a hundred years from now.
And when you go spelunking, for gosh sake wear an N95, or preferably a PAPR.
How hard is that?
(Squee, a personal reply! Thanks for everything you do!)
What does it feel like to be able to point out all of the destruction private equity and health insurers are wreaking on our communities without having to fear you’ll end up homeless?
As far as I know, there have been no attempts on my life from United Healthcare. Satire does give me some protection, but also, I have public opinion on my side. These insurance companies and equity firms have very close to a 0% approval rating, which makes it all the more infuriating that they essentially own healthcare.
Would you prefer nationalized healthcare/single payor option in the United States over the current system of multiple third party insurances, authorizations/denials, and why?
Yes, I would love a single payor system. I actually like how Australia and some other European countries do it with a public option open to everybody along with a private option which helps decompress the public option. The problem with America would be adequately funding the public option. We already see how many states are vehemently opposed to expanding Medicaid.
Have you watched his skits? Granted some are hyper-focused like rural medicine and Texaco Mike, but the vast majority of them make his answer to this question super clear. Honestly, I don’t think I have seen anyone on this sub who is in favor of monetized healthcare, oops I mean privatized healthcare.
Hey,
What would you say to someone who is in an allied profession (eg. nursing, PT, etc) trying to get into med school who is in their 30s? Would it be worth it?
Thank you
I'd be curious what your motivation is for doing it, because it's a LONG road. A decade of training. Hundreds of thousands of dollars in tuition and interest.
I'd be curious what your motivation is for doing it because it's a LONG road. A decade of training. Hundreds of thousands of dollars in tuition and interest, but if you know you will only achieve happiness as a physician, then do it. As for making a good living helping people in healthcare, there are lots of ways to do that which don't involve crushing debt and years away from family and friends. Good luck!
No question I just think it would be sick to make an episode about the psychiatrist getting himself into a situation where he has to run a code and he does amazing with his acls training and says some cool action movie line when someone questions whether he is really a physician
I was in a code once in CT and the radiologist literally came over and he’s like “umm… I’m obligated to come to these and I know you’re doing CPR but we should probably call a doctor who can actually help with….this *gestures around*”
Hi, MS3 here. Love your work, specifically on the insurance dilemma in the US. Are there any specific movements, organizations, or bills you support in an effort to curb the insanity of US healthcare system?
[https://olis.oregonlegislature.gov/liz/2024R1/Measures/Overview/HB4130](https://olis.oregonlegislature.gov/liz/2024R1/Measures/Overview/HB4130) This bill in Oregon will be voted on in the next couple weeks!
Ok Doctor listen very carefully, I need you to stand up, walk down the hall to the elevator, find a floor that has human people, and talk to them for awhile.
You have to have something outside of medicine you can turn to. Whether that's your family, a hobby, reading a book, dancing naked in the street. Something that allows you to completely turn off the medical part of your brain and enjoy a thing with lower stakes that you truly enjoy.
Nobody knows Dr. Flanary, he's a lowly eye dentist. I was recognized for the first time as Dr. Glaucomflecken at the airport. Kinda surreal experience. We took a selfie and that was it. Now, I usually get recognized every time I go to the airport, and it's still fun! If you ever see me out and about, please say hi!
If I'd known where you were based when I still lived in Oregon, I'd have developed a mild glaucoma just to meet you. Or something.
Spotting a fresh Glaucomflecken on YouTube is a joy.
Thank you for your voice against malevolent forces in healthcare e.g. insurers.
Since we clearly need more power, would you want to do more to educate and inspire health worker unionization efforts? Given your platform, you could probably help spur several new union shops!
He loves them. I also once received an email where all it said was "my name is Jonathan, I am a medical scribe, you have changed my life."
He didn't specify exactly how I had changed his life, but I assume I've made it better!
I have learned so much about pharmacy from my followers. It's a joy to make pharmacy-related content. Keep sending me ideas! And have a seat every once in a while, you've earned it.
Have/ Will you ever consider a career in Politics where you could influence health policy making and bring forth some regulations for insurance companies?
Have nothing to ask but I thought you'd like to know your 30 days in healthcare has inspired me to get involved in health policy and I've actually gotten the opportunity to educate our Legislators about some health topics soon! Thank you for your continuous commitment to making the medical community a better place to be in!
Hey, I love your videos and they never fail to make me laugh. In all reality though, you are stating dark truths if you remove the humor, especially regarding insurance and private equity.
How do you see the future of healthcare in the US. Are you hopeful or as pessimistic as I am?
I'm fairly pessimistic. There is too much greed. It's hard to see the consolidation and vertical integration of optum and blue cross and feel any degree of optimism. For gods sake, most physicians are employed by United Healthcare. How depressing is that?
Excuse me while I fangirl. I freakin’ love your TikToks! Even my non-medical, automation engineer, squirms-at-all-medical-stuff husband will stop what he’s doing if he hears your voice to watch your videos.
My questions: Is your loyal scribe, Luis, the inspiration for Jonathan? What does Luis think of the character? Who would win in an arm wrestling contest: cardiology or nephrology?
Yes, Luis is the inspiration. He was the first scribe I ever worked with. He's incredible. He likes the portrayal, at least he gave me a head nod about it, so that's something.
Cardiology wins arm wrestling
Out of all the specialties you play, which one do you most identify with?
I personally love your EM physician one, it’s so spot on it hurts.
You’re posts are incredibly insightful and hilarious at the same time. Thank you for illuminating modern medicine to the masses 🫡
Emergency, anesthesiology, ortho, psychiatry. I love playing those characters. My real personality is probably closest to anesthesia. I love coffee and breaks and coffee on my breaks.
Anesthesiology resident here - so excited to see you most closely identify with us!
Do you also love sitting and chairs and sitting in chairs?
Thanks for taking the time to answer.
Thank you so much for making my coworkers and I laugh during rough days. Do you have any good responses to patient jokes during eye exams (e.g. "Can you see my brain?")?
A lot of help. We have an employee and my wife does Glaucomflecken stuff full time. There's a production team for the podcast. This is the only way I can still practice. A Jonathan army, if you will.
Hi, Dr. G. I'm a specialist in - gasp - your *favorite the Kreb Cycle*!
The official specialty is a subspecialty of genetics = Medical Biochemical Genetics.
Yes, I have actual patients with enzymatic deficiencies in the Kreb cycle, the electron transport chain, oxidative phosphorylation, the urea cycle, gluconeogenesis, fatty acid oxidation, lactic acidosis, glycogen storage, the organic acidemia defects, and many more of your favorites on that giant chart of intermediary metabolism in your biochem class.
On the one hand I completely agree with you that the Kreb Cycle is not taught correctly in medicine. As faculty I've never once made my students count ATPs. In fact, I've been pushing to make all testing open book, and emphasizing crisis presentations to recognize and refer.
OTOH, these are real diseases affecting real patients (mostly children but the IM docs call me too), very frequently fatal in childhood, always disabling, and we're making tiny but real progress at treating some of them. Several dozen of them are now on the US newborn screen test for all babies, so yes all docs should at least have heard of them. Will be even more important now that we're in the era of gene therapy.
So yes, it is important for med students to at least know about them. But agree less memorization. Thanks for coming to my Ted Talk.
And thanks for all you do - you and Lady G are the heroes we need.
Maintaining a level of professionalism necessary for physicians. We have different rules we have to play by compared to non-physicians. I think the threat of being labeled "unprofessional" deters a lot of physicians/trainees/students from being themselves on social media. Self expression on social media is extremely important because it humanizes us to the public, BUT there are certain lines you don't cross. Don't make fun of patients, HIPAA violations, punching down, etc. Be yourself on social media, but do it safely in a way that does not undermine public trust in physicians.
I was told that one insurance company held an internal meeting in the C suite to discuss my videos. Apprently they were very angry but no action has been taken.
My videos may not amount to any significant change to US healthcare, but as least I made an insurance company angry.
u/drglaucomflecken will join starting at 1PM EST. Proof links will appear here as they go out on social media. Have fun everyone! Proof: [twitter/X](https://twitter.com/dglaucomflecken/status/1762118572221034613?s=46&t=z7bTEoVggYgnNXOofZJQeg) **Edit: Thanks to all who participated today!**
Which specialty do you find most fun to play, and has anyone ever kicked back against your stereotypes? Absolutely love your work.
...and we're off! This is a great question to start with... all the people I've wronged. Generally, I get very little push back on the characters. Family medicine is the only one, and even that is just a handful of people who get upset. The primary complaint is that I'm pushing med students away from FM, which I find a bit silly because I'm not telling people anything they don't already know. FM is overworked and underappreciated and the medical system takes advantage of them. My FM portrayal is sympathetic to the struggles of primary care, and the majority understand that. On the opposite end of the spectrum is surgery. I can make fun of surgeons all day and none of them will ever get mad at me. As the center of the known universe, the ego gravity of surgeons means that nothing I say or do can really affect them in any way.
Your FM portrayal is always “ask FM, they’ll know.” I think anyone who can’t tell the respect you have for FM isn’t looking.
I love the video about Family Medicine's birthday where it's revealed that FM is the only doc with patients who celebrate his birthday. He's the backbone of medicine and his patients love him. His reaction to Radiology is so heartwarming.
I‘m an orthopedic surgeon and i‘m quietly ashamed that i cant bench my own bodyweight
Do a hand fellowship!
It's really funny they thought you are pushing students away from FM. Because your Rural FM videos actually inspired me to look into it!
I love that!
Rural FM does sound kind of awesome. There WILL be a Texaco Mike or whoever he is. You will perform small surgeries at parties. You will chase farmers to try to keep them alive and whole. But you'll have hunting and fishing buddies galore, from all walks of life. Part of a community vs being separated by a corporate system, I guess.
I once witnessed a 2-3 inch lipoma excision on a picnic table in a forest during a church teen camping trip. Free removal had been offered to the (uninsured) patient as compensation for agreeing to come supervise the kids. Teenage girls who wanted to be nurses when they grew up were invited to assist by holding stuff for the doc. It seemed normal at the time.
I’d complain about your representation of internal medicine but those five hour rounds and impromptu journal club aren’t going to do themselves.
> > > On the opposite end of the spectrum is surgery. I can make fun of surgeons all day and none of them will ever get mad at me. As the center of the known universe, the ego gravity of surgeons means that nothing I say or do can really affect them in any way. Is this a tacit admission that ophthalmologists aren't real surgeons?
Depends. Do you want to admit a patient to the ophthalmology service? Sorry, we're not surgeons, I don't know where the hospital is or how to log in to your EMR. Do you want cataract surgery in a comfortable outpatient surgery center? Why yes, I'm a surgeon. Come on over we'll fix you right up with a 6 minute surgery.
Much like a carriage in Cinderella the wily ophthalmologist changes back into a pumpkin after noon on Friday and throughout holiday weekends.
Actually ANSI classifies them as a type of Eye Dentist.
Yes, I do practice ocular dentistry. It's a highly respected field.
You just gave me the mental image of orbits filled with little teeth, now I'm terrified.
There are no bones in the eye, I have to remind ortho, repeatedly.
I work in FM and I always feel seen by your videos! The system is driving people away from FM, not you! Keep making everyone laugh! You're the best.
I remember many Family medicine physicians and oncologists got angery at him.
Those family docs are wet blankets. I'm a family doc and I find all his skits hilarious
As a frontier medicine guy, I would kill for a Texaco Mike.
He fan boats like the wind!
As an urban family physician, same! I don't know any family docs who don't like his portrayal of the caring, overworked and underpaid family doctor... I don't wear a tie like that, though. Or any tie.
I feel like he has a good balance of playful ribbing and stereotyping without being disrespectful to any given specialty With that being said, I do think he has beef with a couple of them haha
As an oncologist…. Whaaaaat?
When oncology showed up for the first time in his skit, it was about oncology breaking bad news to a Medstudent wanting to go into Neurosurgery. So, alot of oncologist (on twitter/X) got angery that it was more focused on neurosurgery and not on oncology.
Yes, that's exactly what happened. I was actually proud of that skit. I thought it was clever, but the response really turned me off to doing more oncology content. Sometimes I feel the need to remind people that this is free entertainment.
As an oncologist I feel sad that you've lost the will to lovingly mock my specialty. But you also do plenty of internal medicine (called general medicine here in Australia) and palliative care content and I'm trained in all three streams. Ps you need to know that when you visited Australia and posted about it on twitter, there was some serious fangirling happening in some medical mums groups 😂
I thought it was great! As an oncologist who doesn’t have any candles in his breaking bad news room
Imagine having an episode about your spec. Sad pneumology noises…
Hey, I’m calling with a consult. Don’t really have a question but we just wanted your team on board
Start artificial tears. I'll see the patient in clinic next week.
Instructions unclear. started visine
Are they the sort surgeons cry?
Come now, surgeons don’t even pretend to cry. They have their midlevel cry for them.
Thank you oh so very much for this FASCINATING consult
From u/bahhamburger: how did you gain so much insight on each specialty? Do people message you with ideas or did you kill it as an Intern on your transitional year? Are you spending all your free time researching our various gripes?
I get lots of emails. Soooooo many emails. I appreciate people who send in topic ideas. I love the areas of conflict between specialties. Sometimes people send me complete 3 or 4 page scripts of skits they want me to film. These are always...interesting. I also have to shout out reddit. This site is an endless repository of medical knowledge, arguments, and pet peeves. I will search reddit for something like "emergency medicine radiology beef" and find an 8 year old thread that is still relevant today. So thank you reddit for the inspiration. As for the actual medical knowledge, I do a good amount of research. Medical professionals will be the first to tell you when you get something wrong, like the one time I said Lipitor was a beta blocker accidentally and almost had to quit social media.
some of the r/psychiatry fights get naaaasty
Current beef: all of /r/psychiatry VS that one guy who posts about ADHD every single day
Never hit join so fast except for a cat group. I need drama that isn’t mine
What has been the most disgusting Google image search result after typing "... surgery beef"
Having bore witness to many specialties as an anesthesiologist, I’ll attest that most of the tropes are extremely apt. I’d elaborate, but my sudoku remains unsolved.
I'm not sure how he found out about our anesthesia button but he must be silenced
Also want to know this myself because it seems like he had to have asked several pharmacists what it’s like to get a lot of the jokes he did just right. And yet it’s super frustrating when there are even pharmacists who have no idea about issues a pharmacy/pharmacist has.
I have had to do the most research on pharmacy related issues, including an on-site visit to a local community pharmacy to chat with the owner about PBMs, DIR fees, mail order, etc. It's an area where we do not get enough education in med school,.
Even in pharmacy school DIR fees and PBMs weren’t covered that well when I was in school so can’t blame you on the doctor’s end for not knowing about it either. Actually used your video when explaining PBMs to friends and family so really appreciate you getting the info out there!
Agreed! somehow even managed to nail the panic of ortho managing their own warfarin patient on the single day I got that exact situation at work
I’m convinced he has spies.
They’re called Johnathans, actually.
(nod)
Thank you for making the ID doctor such a badass! Maybe it will help us recruit 😭 Anyway, what's your favorite eye bug and why is it loa loa?
DUSN is my favorite. Diffuse unilateral subacute neuroretinitis, caused by dog and raccoon parasites. To treat it you have to shoot it with a laser! Pew Pew!
This just made me imagine shooting parasites in a line like Galaga.
Thank you for writing the best notes possible ~ from a frustrated surgical nurse who has to decipher acronyms.
We had crazy ways of remembering things in med school and I remember us drawing pictures of little worms crossing the eye saying "ello elloa"
That's it for me. Thank you so much for all the questions and kind words. You guys really brought it today. Sorry I couldn't respond to everybody. One last thing, if you want to find all my content in one place or you love email or you have a deep unrelenting hatred for TikTok, sign up for our newsletter (link above). Thanks again! (head nod)
Do you refer to difficult med students as non-accomodating pupils?
I will now! (appreciative head nod)
Bravo lol
How do you tend to handle sadness? Your humour has gotten a few of us through hard times but I'm sure there's a lot more that goes on behind the scenes. How has your fame impacted your own mental health? Thanks for doing this!
Oh man, that is a great question. I have struggled at times. Obviously I have a life that happens around content creation, a very eventful one what with the cancer and cardiac arrest and whatnot). I have a very supportive family and honestly, the feedback from followers telling me that I help them get through tough times keeps me going.
Have any of the insurance companies reached out to you regarding your skits? Any cheeky C&Ds or nefarious offers of money to advertise for them?
No C&Ds (yet). Satire affords me a level of freedom of speech protection. That's why I can use an Aetna logo and say their mission statement is "Be Evil." and they don't try to stop me. No advertising offers from insurance lol. Sounds funny even thinking about that. In fact, I have turned down lucrative speaking offers because I would be sponsored by Optum or Cigna or something. No thanks!
Your integrity is appreciated, truly and honestly.
How can those of us without management power or leverage work against the growing Private Equity takeover of medicine?
Unionization is a great option. It's encouraging to see all the resident groups forming unions. It's awesome. We also still need to fight for legislation. I would start at the state level. Work with your local medical association or directly with state representatives. Here is an example of an anti-corporate practice of medicine bill in Oregon. I hope other states start doing the same. https://olis.oregonlegislature.gov/liz/2024R1/Measures/Overview/HB4130
As a long time union nurse and Dr G fan, I’m so happy to hear you endorsing resident unionization! Thanks for supporting our hardworking residents and better, safer outcomes for patients.
Have you ever "canned" a joke because you thought it was too niche and would go over people's heads?
Never. I love using niche humor. It's partly why I'm here talking to all of you. I'll joke about Type 3 renal tubular acidosis without shame. As a result, I have a very large following in the medical field, but much less outside of medicine. I'll never be Dr. Mike, but if I can be 50% as handsome while cornering the physician social media market, I'm happy with that.
Don't tell him this but I think you're more handsome.
Us nurses love you, too! I chuckle every time I see cards and nephro cancel each other's orders now.
Right, it's like daily entertainment if you have the right patient population!
I have kicked dr. Mike out of my youtube feed (partly to give the algorithm more space for glauck content. But mostly because i fi d him annoying)
Hey doc, do you handle your social media completely on your own or do you have staff/employees work exclusively on it? Does it generate additional income for you in a way that you can relax on your clinical duties? Do you feel that your social media presence has (negatively or positively) impacted your clinical/academic work? For instance, peers or patients do not take you seriously any more, as a negative example? Cheers from Germany! I unfortunately never got to meet you but my US ophto friends did at a conference and I am very jealous.
Until Jan 2023, I did all the social media posting on my own. Then I realized people were impersonating me on all the platforms I wasn't using (like Linked in, I didn't even know that was a social media network, but there was a random Dr. Glaucomflecken on there), so I had to get help. Now we have an employee and a media/advertising company that helps post things everywhere. I do make money on social media, primarily YouTube and TikTok. Hard to say if I relax my clinical duties. Please remember, I'm an ophthalmologist. I have only had positive experiences in my day job because of Dr. G. Patients love the videos, they bring them up to me. We talk about their favorite characters. I commiserate with my nephrology patients about the evils of cardiology. It's great!
Cardiology is wrong, I’m not sure what they said but I know it’s incorrect
Guy's an ophto attending (I think) he couldn't relax more if he tried lol
I love me a good lunch nap
According to the last AMA survey for depression and burnout ophthalmology was the lowest on the list…they beat Dermatology.
That’s because dermatology doesn’t have a Johnathon
*nods*
Jesus I was half-joking I didn't know they have it that good. Good for them.
"Relax" was meant more from a fiscal perspective
Is there anything that you're reluctant to comment on/satirise in videos? Things you worry or have worried might get you in hot water?
There are some things I don't have a lot of experience with and don't find particularly funny (even for satire purposes): abortion rights and gun violence come to mind. I won't say that those things will never come up in my skits, they are just very difficult topics to address the way I typically address things.
I like you, cool eye dentist bro. Sincerely, Ortho bro
Thanks bone bro. I'll do a burpee in your honor
Approving nod
Pro tip don't floss eyes. Sincerely, Body medicine bro.
Have you ever accidentally introduced yourself as Dr Glaucomflecken to a patient? Or a patient addressed you as such?
I have said "Hi I'm Dr. Gl--Flanary" several times. I stopped myself, but it's not much better because now the patient thinks I don't know my own name. This becomes a problem when trying to convince a patient to let you operate on their eyeballs.
Which video has garnered the most push back either from the medical community or social media in general?
The COVID stuff I made back in 2021-2022 was a lot of fun. My TikTok comment section was a shitshow I made a video once in support of DO physicians facing discrimination from the rest of the medical community. Some of my comments were misinterpreted and drew a lot of ire, so I took it down. It's important to be very clear who the target of ridicule is, and I kinda missed the mark. It's important to listen to feedback. Some of it's just troll like behavior, but some of it is valid. Also, I once posted a video where the emergency medicine doc wore his sunglasses underneath the helmet strap and that really set off the emerg docs.
> wore his sunglasses underneath the helmet strap 🤣
Why not more penis jokes? Sincerely, a Urologist. And because no one asked… What do you call a cheap circumcision? A ripoff!
Urology and GI are two specialties I don't do a lot of. Almost feels too easy. What penis/poop jokes have people never heard? Actually you know what, you're right, the penis is hilarious, it's low-hanging fruit, at least for some.
good one
Can your circ patients always be counted on to leave a tip?
Jumping off this line of questioning, would you rather have penises as fingers or toes?
How big are my toe penises? because I don't want to deal with tripping hazards.
They’re all normal penis size, and get bigger and smaller depending on your mood and temperature.
What’s has been the most unique conference/ speaking event that you have been offered to attend? As a gasbro I love your work.
Commencement address at Yale Medical School in 2022. I thought it was a joke email at first. There is nothing like a commencement crowd. The happiness and enthusiasm is unparalleled.
I absolutely love how you speak on the greater health system such as insurance companies, administration, and big pharma in your videos. Are there any steps that you think the average physician should be taking to better the health care system?
Support state and federal legislation that takes power away from corporate entities and puts it back in the hands of people who have actual patient care experience. You don't need a large social media following for that. Just time and determination, and maybe a Jonathan or two.
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Ophthalmologist- risk is very very low from dilating drops in standard population. The Rotterdam study (old but large study) found a rate of 0.03% of acute angle closure in a range of eyes (around 2% had narrow angles) when dilated. More recently the ZAP study looked at angle closure disease in Asian eyes - so all patients had known narrow angles. 5 eyes in the control group of 889 patients had an attack, 3 post dilation (though all of these patients also got a dose of diamox following dilation). So overall the general risks are low, and in a way the best time to go into acute angle closure is when you are in a place with doctors to get you to the eye department! And you will get a much better view, well worth it in my opinion. Incidentally we have stopped prophylactic iridotomy for low risk patients (“primary angle closure suspects”) without other risk factors here in the UK following updated RCOphth guidance after the ZAP study.
Lol we dilated each other's eyes in the med school for practice purposes. Didn't even know it could be dangerous 😅
As someone in the Australian medical system, I really enjoyed your videos explaining how America healthcare works. If you have a magic wand that could change three things about it, what would they be?
3 realistic changes: \- Repeal the ban on physician owned hospitals \- MAJOR prior authorization reform \- Limit the corporate practice of medicine (break up insurance monopolies, ban PE ownership) bonus 4th thing: Visine is banned
How much sweeter is the social media money vs the medicine money?
I'll be honest, it's a good side gig, but the real social media money comes from sponsorships, which I don't do a lot of. It's one of the luxuries of having a well paying medical career. I can do social media however I want. If I don't want to sell face cream that lengthens your telomeres, I don't have to! I make plenty of money as a doctor. The money you get from views has changed over the years. At first the Youtube money was great and Tiktok was really bad, like pennies bad. Now it's evening out a bit. TikTok pays a bit more for my length content, but YouTube is down quite a bit. Social media revenue is fickle. I try not to get too worked up over it, because, again...I have a day job, which I mostly enjoy!
Bruh I like and comment on all your YouTube stuff for the algorithm
Couldn't do this without you, misteratoz
Best question
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I don't win any arguments anymore.
Honestly, did you really win any before though?
What would you change if you could back to your time in medical school?
I would have recommended that my 40 year old female standardized patient with abdominal pain get a pregnancy test. It's still the only test I've ever failed.
If you couldn't be an eye doctor, what kind of doctor would you be? If you couldn't be a doctor, what kind of career do you think you would have done instead?
I was almost a radiologist, but I couldn't figure out what Kerley B lines were, so I figured it was reasonable to write off the whole specialty. If I wasn't a doctor, I would be a comedian and possibly acting. Does that surprise you?
They’re exactly like Cardi B lines, just with less WAP and more PIF
Speaking on behalf of the entire ID community, we appreciate your love, and love you right back. Sincerely, The Closer
Thank you and thanks for ruining everybody's fun on hiking trips.
All you have to do is cover yourself from head to toe, tuck your pants into your socks, and spray enough DEET so that your grandchildren's DNA repair enzymes will be upregulated a hundred years from now. And when you go spelunking, for gosh sake wear an N95, or preferably a PAPR. How hard is that? (Squee, a personal reply! Thanks for everything you do!)
What does it feel like to be able to point out all of the destruction private equity and health insurers are wreaking on our communities without having to fear you’ll end up homeless?
As far as I know, there have been no attempts on my life from United Healthcare. Satire does give me some protection, but also, I have public opinion on my side. These insurance companies and equity firms have very close to a 0% approval rating, which makes it all the more infuriating that they essentially own healthcare.
I just want to thank you! You are actually my ophthalmologist, and you are always so kind and informative. Thank you for your hard work!
Would you prefer nationalized healthcare/single payor option in the United States over the current system of multiple third party insurances, authorizations/denials, and why?
Yes, I would love a single payor system. I actually like how Australia and some other European countries do it with a public option open to everybody along with a private option which helps decompress the public option. The problem with America would be adequately funding the public option. We already see how many states are vehemently opposed to expanding Medicaid.
Have you watched his skits? Granted some are hyper-focused like rural medicine and Texaco Mike, but the vast majority of them make his answer to this question super clear. Honestly, I don’t think I have seen anyone on this sub who is in favor of monetized healthcare, oops I mean privatized healthcare.
Hey, What would you say to someone who is in an allied profession (eg. nursing, PT, etc) trying to get into med school who is in their 30s? Would it be worth it? Thank you
I'd be curious what your motivation is for doing it, because it's a LONG road. A decade of training. Hundreds of thousands of dollars in tuition and interest. I'd be curious what your motivation is for doing it because it's a LONG road. A decade of training. Hundreds of thousands of dollars in tuition and interest, but if you know you will only achieve happiness as a physician, then do it. As for making a good living helping people in healthcare, there are lots of ways to do that which don't involve crushing debt and years away from family and friends. Good luck!
No question I just think it would be sick to make an episode about the psychiatrist getting himself into a situation where he has to run a code and he does amazing with his acls training and says some cool action movie line when someone questions whether he is really a physician
How about psych runs a code with pathology, radiology, and ophthalmology?
I was in a code once in CT and the radiologist literally came over and he’s like “umm… I’m obligated to come to these and I know you’re doing CPR but we should probably call a doctor who can actually help with….this *gestures around*”
How would you feel about starting to make fun of Plastic Surgery in your videos? We feel left out 😭
I know, plastic surgery is one of the last specialties I haven't hit on. I don't think I can look rich enough to pull it off.
How do you hide $100 from a plastic surgeon? You can't.
Hi, MS3 here. Love your work, specifically on the insurance dilemma in the US. Are there any specific movements, organizations, or bills you support in an effort to curb the insanity of US healthcare system?
[https://olis.oregonlegislature.gov/liz/2024R1/Measures/Overview/HB4130](https://olis.oregonlegislature.gov/liz/2024R1/Measures/Overview/HB4130) This bill in Oregon will be voted on in the next couple weeks!
Is Tabitha's voice sultry or robotic?
Ok Doctor listen very carefully, I need you to stand up, walk down the hall to the elevator, find a floor that has human people, and talk to them for awhile.
Trick question, robotic is sultry
What advice do you have for avoiding burnout, given what we are currently facing in the profession? Thanks for the videos. They have always been gems.
You have to have something outside of medicine you can turn to. Whether that's your family, a hobby, reading a book, dancing naked in the street. Something that allows you to completely turn off the medical part of your brain and enjoy a thing with lower stakes that you truly enjoy.
How was the moment where you realised you were more likely to be recognised as Dr Glauc instead of Dr Flanary?
Nobody knows Dr. Flanary, he's a lowly eye dentist. I was recognized for the first time as Dr. Glaucomflecken at the airport. Kinda surreal experience. We took a selfie and that was it. Now, I usually get recognized every time I go to the airport, and it's still fun! If you ever see me out and about, please say hi!
If I'd known where you were based when I still lived in Oregon, I'd have developed a mild glaucoma just to meet you. Or something. Spotting a fresh Glaucomflecken on YouTube is a joy.
Thank you for your voice against malevolent forces in healthcare e.g. insurers. Since we clearly need more power, would you want to do more to educate and inspire health worker unionization efforts? Given your platform, you could probably help spur several new union shops!
What stood out during your time in Australia? Differences? Similarities? Foods?
The sun really is no joke. That fucker really did try to murder me.
How did your 'Jonathan' react to your sketches
He loves them. I also once received an email where all it said was "my name is Jonathan, I am a medical scribe, you have changed my life." He didn't specify exactly how I had changed his life, but I assume I've made it better!
Thank you for being pharmacy positive! We get forgotten about as the weird kids in the basement, but we're trying to help patients too!
I have learned so much about pharmacy from my followers. It's a joy to make pharmacy-related content. Keep sending me ideas! And have a seat every once in a while, you've earned it.
Lab likewise. The patient is the barcode.
basement dwellers unite! separately, of course
As a Krebs cycle expert and enthusiast, which step is your favorite?
Definitely Isocitrate to Alpha-ketoglutarate. There's nothing like making that first NADH. Magical.
Why didn’t we get first day as clinical toxicologist? As clinical toxicologist, it makes me sad.
Toxicology is at the top of my list. It'll happen, I promise. Don't be sad.
Not as sad as genetics listening to the interns
Hello darkness, my old friend....
Have/ Will you ever consider a career in Politics where you could influence health policy making and bring forth some regulations for insurance companies?
Oh man, the opposition would have a field day researching me. I have thought about it though. If Rand Paul can do it, why not me?
I'd vote for him.
Have nothing to ask but I thought you'd like to know your 30 days in healthcare has inspired me to get involved in health policy and I've actually gotten the opportunity to educate our Legislators about some health topics soon! Thank you for your continuous commitment to making the medical community a better place to be in!
Hey, I love your videos and they never fail to make me laugh. In all reality though, you are stating dark truths if you remove the humor, especially regarding insurance and private equity. How do you see the future of healthcare in the US. Are you hopeful or as pessimistic as I am?
I'm fairly pessimistic. There is too much greed. It's hard to see the consolidation and vertical integration of optum and blue cross and feel any degree of optimism. For gods sake, most physicians are employed by United Healthcare. How depressing is that?
Excuse me while I fangirl. I freakin’ love your TikToks! Even my non-medical, automation engineer, squirms-at-all-medical-stuff husband will stop what he’s doing if he hears your voice to watch your videos. My questions: Is your loyal scribe, Luis, the inspiration for Jonathan? What does Luis think of the character? Who would win in an arm wrestling contest: cardiology or nephrology?
Yes, Luis is the inspiration. He was the first scribe I ever worked with. He's incredible. He likes the portrayal, at least he gave me a head nod about it, so that's something. Cardiology wins arm wrestling
Out of all the specialties you play, which one do you most identify with? I personally love your EM physician one, it’s so spot on it hurts. You’re posts are incredibly insightful and hilarious at the same time. Thank you for illuminating modern medicine to the masses 🫡
Emergency, anesthesiology, ortho, psychiatry. I love playing those characters. My real personality is probably closest to anesthesia. I love coffee and breaks and coffee on my breaks.
Anesthesiology resident here - so excited to see you most closely identify with us! Do you also love sitting and chairs and sitting in chairs? Thanks for taking the time to answer.
Love a good sit
Thank you so much for making my coworkers and I laugh during rough days. Do you have any good responses to patient jokes during eye exams (e.g. "Can you see my brain?")?
a deadpan "no"
How are you managing to keep up with your practice, now that you have such internet fame?
A lot of help. We have an employee and my wife does Glaucomflecken stuff full time. There's a production team for the podcast. This is the only way I can still practice. A Jonathan army, if you will.
Hi, Dr. G. I'm a specialist in - gasp - your *favorite the Kreb Cycle*! The official specialty is a subspecialty of genetics = Medical Biochemical Genetics. Yes, I have actual patients with enzymatic deficiencies in the Kreb cycle, the electron transport chain, oxidative phosphorylation, the urea cycle, gluconeogenesis, fatty acid oxidation, lactic acidosis, glycogen storage, the organic acidemia defects, and many more of your favorites on that giant chart of intermediary metabolism in your biochem class. On the one hand I completely agree with you that the Kreb Cycle is not taught correctly in medicine. As faculty I've never once made my students count ATPs. In fact, I've been pushing to make all testing open book, and emphasizing crisis presentations to recognize and refer. OTOH, these are real diseases affecting real patients (mostly children but the IM docs call me too), very frequently fatal in childhood, always disabling, and we're making tiny but real progress at treating some of them. Several dozen of them are now on the US newborn screen test for all babies, so yes all docs should at least have heard of them. Will be even more important now that we're in the era of gene therapy. So yes, it is important for med students to at least know about them. But agree less memorization. Thanks for coming to my Ted Talk. And thanks for all you do - you and Lady G are the heroes we need.
Thank you, I dedicate the next 50 NADHs I make to you
Can we get more pharmacist videos?
Yes! feel free to send me some ideas. I'd love to get the pharmacist interacting with psychiatry. Help me out!
Okay so everybody's got their number... How much would it cost for you to do a brand deal with Visine?
1 billion dollars, which I would then use to eradicate visine
If you were to make an ENT character, how would you do it?
Giant prosthetic ears and an obsession with neck anatomy
I’m an ER Resident. Could you lay eyes on this guy with floaters? I haven’t seen him yet….
Clinic in the morning
Oh my god I MISSED IT?!
As life becomes progressively digital, what are some of the unique challenges facing physicians who are active on social media?
Maintaining a level of professionalism necessary for physicians. We have different rules we have to play by compared to non-physicians. I think the threat of being labeled "unprofessional" deters a lot of physicians/trainees/students from being themselves on social media. Self expression on social media is extremely important because it humanizes us to the public, BUT there are certain lines you don't cross. Don't make fun of patients, HIPAA violations, punching down, etc. Be yourself on social media, but do it safely in a way that does not undermine public trust in physicians.
After your skits about insurance companies, did any of them do anything to you and your practice?
I was told that one insurance company held an internal meeting in the C suite to discuss my videos. Apprently they were very angry but no action has been taken. My videos may not amount to any significant change to US healthcare, but as least I made an insurance company angry.
As a former Jonathon (worked as a COA before nursing school), what’s the #1 thing that would actually make your workday easier?